Critically discuss the case for counselling to be evaluated through randomised controlled trials.
In the following essay a critical discussion for the case for counselling to be evaluated through randomised controlled trails will be discussed. A randomised control trial requires firstly finding a collection of individuals who are all in search of help and who have a comparable problem. These can be identified through the use of a questionnaire for example, by comparing outcome scores. These clients are then randomly allocated to various treatment circumstances. The client will then be allocated to a specific type of therapy or a therapy associated to a control condition, or a contrast with a placebo condition. The client’s level of angst, melancholy, fears or other difficulties are measured before therapy, at the end of therapy and again at a later date. (McLeod, 2003) One of the largest RCT’s to date is the National Institute of Mental Health Treatment of Depression Collaborative Research Programme. (Elkin, 1994; Elkin et al., 1989) The project involved three research locations in which 250 clients were randomly assigned to four treatment conditions. Two of which were psychotherapies, cognitive behavioural therapy and interpersonal psychotherapy, thirdly Imipramine (a drug) plus clinical management, finally a placebo condition was used for the most part as a control for the drug condition but also as an flawed control for the two psychotherapies. Amid the characteristics of the project separate therapists were used in the two opposing psychotherapies. This is described as ‘nested’ in which the therapist provides only one specific treatment rather than providing all treatments. The specific treatment was then recorded in training manuals and the delivery of the treatments were scrutinized to check the therapists dedication to the treatment procedures. This is an example of the research calling for a level of influence and supervision of the delivery...
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